Abstract

Screening for colorectal cancer: European guidelines for quality assurance According to the most recent estimates by the International Agency for Research on Cancer (IARC) colorectal cancer (CRC) is the most common cancer in Europe and it is one of the most causes of cancer death in Europe. Worldwide CRC ranks third in incidence and fourth in mortality with an estimated 1.2 million cases and 0.6 million deaths annually. In the 27 Member States of the European Union (EU), CRC ranks first in incidence and second in mortality in both sexes, with approximately 334 000 new cases and 149 000 deaths estimated for men and women combined in 2008. Even in those Member States in the lower range of age-standardised rates of CRC, the burden of disease is significant compared to other regions of the world. CRC is therefore an important health problem across the EU. Screening is an important tool in cancer control in countries with a significant burden of CRC, provided the screening services are of high quality. The EU recommends population-based screening for breast, cervical and colorectal cancer using evidence-based tests with quality assurance of the entire screening process including diagnosis and management of patients with screen-detected lesions. In this context, multidisciplinary evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the IARC. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The content of the executive summary is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of screening programmes and services.